Background: Ethically difficult situations are frequently encountered by healthcare professionals. Moral case deliberation is one form of clinical ethics support, which has the goal to support staff to manage ethical difficulties. However, little is known which difficult situations healthcare teams need to discuss. Aim: To explore which kinds of ethically difficult situations interprofessional healthcare teams raise during moral case deliberation. Research design: A series of 70 moral case deliberation sessions were audio-recorded in 10 Swedish workplaces. A descriptive, qualitative approach was (...) applied, using thematic content analysis. Ethical considerations: An advisory statement specifying no objections to the study was provided from an Ethical Review Board, and consent to be recorded was assumed by virtue of participation in the moral case deliberation. Findings: Three themes emerged: powerlessness over managing difficult interactions with patients and next-of-kin, unease over unsafe and unequal care, and uncertainty over who should have power over care decisions. The powerlessness comprised feelings of insufficiency, difficulties to respond or manage patient’s/next-of-kin’s emotional needs or emotional outbursts and discouragement over motivating patients not taking responsibility for themselves. They could be uncertain over the patient’s autonomy, who should have power over life and death, disclosing the truth or how much power next-of-kin should have. Discussion: The findings suggest that the nature of the ethically difficult situations brought to moral case deliberations contained more relational-oriented ethics than principle-based ethics, were permeated by emotions and the uncertainties were pervaded by power aspects between stakeholders. Conclusion: MCD can be useful in understanding the connection between ethical issues and emotions from a team perspective. (shrink)

Background: Moral Case Deliberation is one form of clinical ethics support described as a facilitator-led collective moral reasoning by healthcare professionals on a concrete moral question connected to their practice. Evaluation research is needed, but, as human interaction is difficult to standardise, there is a need to capture the content beyond moral reasoning. This allows for a better understanding of Moral Case Deliberation, which may contribute to further development of valid outcome criteria and stimulate the normative discussion of what Moral (...) Case Deliberation should contain. Objective: To explore and compare the content beyond moral reasoning in the dialogue in Moral Case Deliberation at Swedish workplaces. Methods: A mixed-methods approach was applied for analysing audio-recordings of 70 periodic Moral Case Deliberation meetings at 10 Swedish workplaces. Moral Case Deliberation facilitators and various healthcare professions participated, with registered nurses comprising the majority. Ethical considerations: No objection to the study was made by an Ethical Review Board. After oral and written information was provided, consent to be recorded was assumed by virtue of participation. Findings: Other than ‘moral reasoning’ (median (md): 45% of the spoken time), the Moral Case Deliberations consisted of ‘reflections on the psychosocial work environment’ to a varying extent (md: 29%). Additional content comprised ‘assumptions about the patient’s psychosocial situation’ (md: 6%), ‘facts about the patient’s situation’ (md: 5%), ‘concrete problem-solving’ (md: 6%) and ‘process’ (md: 3%). Conclusion: The findings suggest that a restorative function of staff’s wellbeing in Moral Case Deliberation is needed, as this might contribute to good patient care. This supports outcome criteria of improved emotional support, which may include relief of moral distress. However, facilitators need a strategy for how to proceed from the participants’ own emotional needs and to develop the use of their emotional knowing to focus on the ethically difficult patient situation. (shrink)

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by (...) those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by (...) those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

I begin by reviewing some recent work on the status of the geodesic principle in general relativity and the geometrized formulation of Newtonian gravitation. I then turn to the question of whether either of these theories might be said to ``explain'' inertial motion. I argue that there is a sense in which both theories may be understood to explain inertial motion, but that the sense of ``explain'' is rather different from what one might have expected. This sense of explanation is (...) connected with a view of theories---I call it the ``puzzleball view''---on which the foundations of a physical theory are best understood as a network of mutually interdependent principles and assumptions. (shrink)

The issue of Scientology and the media is in some ways an extension of the discussion of Scientology and controversy, and in other ways not. James R. Lewis’s “Scientology vs. the Media” surveys the larger question. In some ways, the Church of Scientology is but a case study of the larger media controversy surrounding new religions in general. From another perspective, Scientology’s Guardians Office was a uniquely vicious agency that, in the name of protecting the Church, ended up providing (...) the basis for yet harsher criticisms. For many years, the Church of Scientology kept up a sustained attack against hostile outsiders. But it was with the emergence of the Internet that the Church of Scientology finally met its Waterloo. (shrink)

James Adam was a Scottish classics scholar who taught at Emmanuel College, Cambridge. A strong defender of the importance of Greek philosophy in a well-rounded education, Adam published a number of Plato's works including Protagoras and Crito. This two-volume critical edition of the Republic was another major contribution to the field. Though his preface claims 'an editor cannot pretend to have exhausted its significance by means of a commentary,' Adam's depth of knowledge and erudite analysis of the Greek text (...) ensured that his edition remained the standard reference for decades to follow, and it remains a thought-provoking evaluation of one of the great works of Western thought. Volume 1 is devoted to Books 1–5, which discuss justice and the ideal society. (shrink)

This article uses the case of “social impact bonds” (SIBs) to explore the role of social science methods in new markets in “social investment.” Pioneered in the UK in 2010, SIBs use private capital to fund social programs with governments paying returns for successful outcomes. Central to the SIB model is the question of evaluation and the method to be used in determining program outcomes and investor returns. In the United States, the randomized controlled trial (RCT) has been the dominant (...) method. However, this has not been without controversy. Some SIB practitioners and investors have argued that, while this may be the perfect tool, the need to grow the SIB market demands a more pragmatic approach. Drawing from a three-year study of SIBs, and informed by Science and Technology Studies (STS)-inspired work on valuation and the social life of methods, the article explores RCTs as both a valuation technology central to SIB design and the object of a micropolitics of valuation which has impeded market growth. It is the relationship between, and the politics of, evaluation and valuation that is a key lesson of the SIB experiment and an important insight for future research on “social investment” and other settings where methods are constitutive of financial value. (shrink)

Within the corporate social responsibility research field, the construct of organizational reputation has been extensively scrutinized as a crucial mediator between the firm CSR engagement and valuable organizational outcomes. Yet, the existing literature on organizational reputation suffers from substantive divergence between the studies in terms of defining the construct’s domain, dimensional structure, and the methodological operationalization. The current study aims to refine the organizational reputation construct by reconciling varying theoretical perspectives within the construct’s definitional landscape, suggesting a holistic but parsimonious (...) triadic view on the organizational reputation construct for customer stakeholders. Based on commonly used extant organizational reputation measures, we theoretically and empirically develop the customer-based triadic organizational reputation scale and position it as a superordinate multidimensional construct influencing three distinct first-order dimensions: product and service efficacy, societal ethicality, and market prominence. Results show that the proposed triadic conceptualization of organizational reputation is theoretically defensible, and the resulting scale is cross-culturally generalizable and performs well compared with existing, longer measures of organizational reputation. Together, the organizational reputation model developed here suggests that, for cognitive economy and functional efficiency, customers will access a second-order reflective model of organizational reputation as the default implicit attitude, which in turn will activate reflections of the implicit attitude in the form of first-order dimensions. (shrink)

Caton d’Utique est parfois présenté comme un exemple d’agent moral ayant toujours agi avec honnêteté. Il refuse tout compromis moral. J’analyse ici comment les auteurs antiques présentent cette honnêteté comme une forme d’inaptitude, plus précisément une inaptitude à envisager toute action injuste, et comment cela est présenté comme une forme d’obstination et d’échec empêchant d’interagir avec les gens tels qu’ils sont réellement. Je compare ces anciennes représentations et ces jugements sur Caton avec le traitement des « saints moraux » par (...) Susan Wolf. (shrink)

It may seem reasonable, even inevitable, that architectural practice should be based on an understanding that architects, like lawyers and doctors, should discover their clients' needs and accommodate them to the best of their abilities. But current discussion within the legal and medical professions of the conflict between service to private individuals who can pay, and to the public who cannot, suggest an expanded or altered definition of professional responsibility. Actually, the conflict between public and private interest may be more (...) acute in architecture than in other professions: the kind of buildings architects design are costly and are made possible only by the wealth of a small segment of the population or the state, yet every one raised affects the lives of people other than the one who makes the program and pays the architect for his services. Furthermore, the decisions of architects are embodied in buildings that last for generations, even for millennia, so that the overwhelming majority of people in our culture live and work in places designed not only for other people but for other times and conditions. For this reason, even the "private" practice of architecture involves responsibilities to a widespread constituency. James S. Ackerman is the author of The Architecture of Michelango, Art and Archaeology, The Cortille del Belvedere, Palladio and Palladio's Villas and is professor of fine arts at Harvard University. He has contributed "On Judging Art without Absolutes" to Critical Inquiry. (shrink)

Originally published in in 1893, this book contains the text of the Socratic dialogue Protagoras, which discusses a variety of Sophistic and Socratic tenets, including the teachability of virtue. The dialogue also provides an interesting view on the connection between pederasty and education in ancient Athens. Notable Plato scholars James and Adele Adams present an introduction addressing the purpose and themes of the dialogue; a biography of Protagoras and extant fragments of his works are also included. This book will (...) be of value to anyone with an interest in the Platonic, Socratic or Sophistic philosophies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:SPLUTTERING UP THE BEACH TO NINEVEH... James Alison Rio de Janeiro I. Fleeing from the Word Jonah, ifyou remember, was a most unwilling prophet. The word of God came to him, telling him to go and preach against the great city ofNineveh, for its wickedness had come up before God. Jonah immediately went in the opposite direction. Rather than heading across the fertile crescent to Nineveh, he rushed (...) down to Jaffa and booked passage on a ship. Scripture tells us that he went on board, to go with them to Tarshish, away from the presence of the Lord (Jon 1,3) Not only was Tarshish quite the wrong way to go, it was a serious attempt to get away from the presence of the Living God. Why was Jonah so frightened? What was it about Nineveh that scared him? We get a clue later, when Jonah gets cross with Nineveh for repenting on cue. He hated Nineveh. He wanted it to be destroyed. He knew it to be wicked. Why go somewhere which should be destroyed and shout at its inhabitants to change their ways? They will probably give the messenger a rough time! Jonah did not appreciate that he was being sent to Nineveh for the good ofthe people there, yes, but also for his own good. At the end ofthe story he tells God that he hadn't wanted to go because he knew God was a loving God, and was too 'This talk originated as a presentation for the third annual conference ofthe Roman Catholic Caucus of the Gay and Lesbian Christian Movement held in London in March 1999. James Alison109 angry at the thought that the people ofNineveh would get off so lightly. But we're not told that at this stage. Jonah is the son of Amittai, which is to say son of "My Truth." So the whole story is set up from the beginning as one in which someone who is wedded to their own truth comes to learn God's truth the hard way. He knows what is wrong with the gentile world, but was at first able to hear only half of the word of God. He heard it as he was able to receive it: as a stern word of rebuke that he was to pass on to others. That was the state of his soul. Luckily, God had chosen someone who, invincible as he was in his righteousness, knew perfectly well that it is a terrible thing to fall into the presence ofthe living God, and suspected, at some level ofhis being that if, he, Jonah were to obey God, God would certainly break through the carapace ofordered adhesion to true religion, and come into contact with a much more turbulent, stormy world, the world of shame and fear and hatred that is the underside ofall ordered righteousness. Shame is a compulsion which heeds only one command: flee! And Jonah fled. Thank heaven for Jonah's flight! Think how much more damage is caused by those who are not vulnerable to their own shame, who really do manage to fool themselves that their righteousness and God's are cut from the same cloth. Something in Jonah's being was vulnerable to the suspicion that the word ofthe living God would wreak havoc with his own carefully covered hatred and fear, the suspicion that that hatred ofothers and fear of himselfwere aspects ofthe same as yet unredeemed dimension ofhis own life. In that vulnerability was his flight, and through it, ultimately, he was reached so as to be taught how to be a bearer ofGod's word. Andrew Sullivan has a line which catches this dynamic exactly: "Shame forces you prematurely to run away from yourself; pride forces you prematurely to expose yourself. Most gay lives, I'm afraid, are full of an embarassing abundance ofboth."2 Faced with the prospect ofshouting at an incomprehending Nineveh with the hollow pride of those who love neither themselves nor those whom they must convince, Jonah, who knew at the root ofhis heart that he had been giveln something to say, went, as many of us do, into exile. Shame forced him prematurely to... (shrink)

That art historians have felt it necessary to emulate this effort to express personal input can be explained by our need to gain credibility in that aspect of our work that is indistinguishable in method from other historical research: the reconstruction, through documents and artifacts, of past events, conditions, and attitudes. Most of us simply ignore the ambivalence of our position; I cannot recall having heard or read discussions of it, but it is bound to creep out from under the (...) rug. If a student asks me why I think Rembrandt and Picasso are good artists—which most students are too well trained to do—and if I answer that judgments of value are not discussed by historians, I am within my rights, like a witness at a congressional hearing claiming the protection of the Fifth Amendment. But I ought to be found in contempt of the classroom. And if I try to answer seriously, I ought not begin by saying that I chose Rembrandt because he has been acknowledged by generations to have been a great artist but rather because I find more to think, feel, and speak about in his works than in those of, for example, Nicolaes Maes, and because I believe that the student stands to gain more by looking at them. I want the student to have the most rewarding experiences, and, as a result, perhaps to learn to make value discriminations of his own—even ones different from mine and from the so-called consensus of history—and ultimately to explain the grounds on which he makes them. This means having to know and to explain what I think is "rewarding." James S. Ackerman, professor of fine arts at Harvard University, is the author of, among other works, The Architecture of Michelangelo, Art and Archaeology, The Cortile del Belvedere, and Palladio. He is currently writing on Renaissance art, science, and naturalism and making a film on Andrea Palladio and his influence in America. "Transactions in Architectural Design," his previous contribution to Critical Inquiry, appeared in the Winter 1974 issue. (shrink)

James Warren responds to Sandis's preceding article.

James Yerkes undertakes a systematic exploration of the full range of Hegel’s works to discover what philosophical, religious, and historical significance Hegel attributed to the Christian witness that Jesus of Nazareth was the Christ.

This scarce antiquarian book is a facsimile reprint of the original. Due to its age, it may contain imperfections such as marks, notations, marginalia and flawed pages. Because we believe this work is culturally important, we have made it available as part of our commitment for protecting, preserving, and promoting the world's literature in affordable, high quality, modern editions that are true to the original work.

'" -Daniel Cottom, David A. Burr Chair of Letters, University of Oklahoma Cruel Delight: Enlightenment Culture and the Inhuman investigates the fascination with joyful malice in eighteenth-century Europe and how this obsession helped inform ...

Historians and commentators have long discussed tensions between specialist and lay expertise in the making of scientific knowledge. Such accounts have often described quarrels over the distribution of expertise in nineteenth-century “popular” and imperial sciences. The “crowdsourcing” of science on a global scale, however, arguably began in the early modern era. This essay examines the lists of specimen suppliers, the artifacts of a worldwide collecting campaign, published by the London apothecary James Petiver at the turn of the eighteenth century. (...) Listing suppliers helped Petiver advertise his status as a global specimen broker in the Republic of Letters. However, publicly listing his sources drew criticism over the social character of his collecting project, while lists became synonymous with the debasement of learning in polemics over natural history. (shrink)

This paper considers the potential for the Mental Capacity Act of England and Wales to incentivise the exclusion of people with dementia from research. The MCA is intended to standardise and...

In lieu of an abstract, here is a brief excerpt of the content:32. HUME'S CLASSICAL THEORY OF JUSTICE1 Let me begin by formulating a broad distinction between two sorts of theories of justice. I shall stipulate that a modern theory of justice is one which treats justice as a moral quality, in fact as one moral quality among a multitude of moral virtues, and which accordingly takes the obligation tö' be just as pre-eminently a moral obligation. On this approach the (...) philosophical appreciation of justice requires that we interpret it in terms of a moral theory, and correspondingly any viable moral theory is expected to afford a framework within which the virtue of justice is to be understood. The important philosophical question to be asked about justice concerns the moral obligation to abide by the conventions and rules of justice. By a classical theory of justice I mean one which treats this quality not as one moral virtue among many others but as fundamental to morality itself. Here justice would have to be explained before one could develop a satisfactory account of morality. Questions about the moral obligation of justice are on this approach not as important philosophically as questions about the basis of justice itself. The modern and the classical theories are distinguished by the relationship each posits between justice and morality. In the modern approach, the account one offers of morality conditions the account one can offer of justice, while in the classical theory the account one offers of justice conditions the account one can offer of morality. As exemplifying a classical theory of justice one might cite Plato's Republic or, closer to the present topic, Hobbes' De Homi ne. While there seems to be no definitive interpretation of Hobbes ' overall moral and political theories, in this work he maintains that the development of a settled morality is subsequent to the establishment of civil society and therein, of course, also of the order of justice. The following passage from the De Homine shows how the order 33. of civil justice plays a foundational role relative to the moral order. Eut whatsoever is the object of any man's appetite or desire, that is it which he for his part calleth good: and the object of his hate and aversion, evil; and of his contempt, vile and inconsiderable. For these words of good, evil, and contemptible, are ever used with relation to the person that useth them: there being nothing simply and absolutely so; nor any common rule of good and evil, to be taken from the nature of the objects themselves; but from the person of the man, where there is no commonwealth; or, in a commonwealth, from the person that representeth it; or from an arbitrator or judge, whom men disagreeing shall by consent set up, and make his sentence the rule thereof. 2 Attributing to Hobbes the view that the account one gives of justice and the civil order conditions and serves as a necessary presupposition to the account one can give of a settled morality permits us to count Hobbes among those thinkers who have offered a classical theory of justice. Because Hume seems in so many ways to deserve the appellation of thoroughly modern philosopher, it is not surprising that he is naturally construed as sharing in the modern conception of justice. I want to argue that this way of interpreting Hume is mistaken and that he is in fact a classical theorist of justice. I shall contend, furthermore, that getting clear about the kind of theory of justice Hume offers allows us to resolve a problem in his moral theory—specifically a problem relating to the correction of the moral judgment. In view of these aims, the paper has three parts: (1) investigation as to what kind of theory of justice Hume offers; (2) exploration of a quandary inherent in the modernist interpretation which serves as an objection to the thesis of this paper; and (3) resolution of this objection and conclusion as to the character of Hume's theory of morality. At the end I shall explore a few corollaries 34. of the thesis that Hume is a classical theorist of justice. 1. Hume: A Classical Theorist of Justice There are... (shrink)

In a recent paper, Maslow has suggested that we turn from means-centering to problem-centering in science. In two other papers the present author offered a theoretical foundation which would make Maslow's suggestions psychologically sound. For as he suggests, it is only by centering ourselves towards the task that the task is accomplished or towards the problem that the problem is solved. This does not mean that methods or means, or, in the broader sense, of means as ends or of ends (...) per se, do not constitute problems. The whole problem of psychology is the means by which the organism obtains knowledge; the problem of education is that of means, or the problem of communication is one of means, or of any profession, e.g., engineering or medicine, the problem may be of means as a problem. Whichever is the case it is only so far as problems are solved that we are free to go on to tackle new ones or throw light on the more basic ones and thus enrich our lives. Problem solving, of course, does not mean that particular problems as framed are solvable. For example, if the rules state that one must connect each dot with every other dot on a piece of paper with lines that do not intersect, a four dot problem is solvable but a five dot situation cannot be resolved within these rules. In the latter case it may mean that the problem becomes: “can anyone solve it?” This has been the lesson of the mathematicians and the logical positivists. But what is problem solving? (shrink)

Philosophers of science have largely taken little interest in developments in contemporary medicine. There is a familiar, if largely unspoken and undefended, picture of medical research that seems to put it at the periphery of science proper. On this view, medicine is akin to other applied disciplines whose primary aim is to solve particular problems. Scientific research would then be important to medicine only in so far as it sets one kind of constraint on the problem solving process. A second (...) kind of constraint would be set by considerations of value, because the choice, ultimately, is of a course of action, a means to achieving a particular goal. Both the goals that are sought, and the means selected for getting there, are open to evaluation. This normative constraint is, then, added as a kind of second filter, operating on the already given scientific understanding of the parts and processes involved. This view of the relationship between medicine and biology emphasizes a strong discontinuity in explanatory style with the introduction of this separate normative frame. ;A second view might be called an assimilationist view. This view suggests that medical explanations are simply a kind of biological explanation, suggesting that both are value-neutral and that it is a mistake to see a normative frame playing any role in medical explanations. I argue against both of these positions, and defend an account of the relationship between biological explanations and medical explanations that emphasizes their continuity. ;I argue that both medicine and biology rely on a similar understanding of the nature of living creatures. A proper understanding of this underlying picture reveals that medical and biological explanations are extensions of an essentially similar explanatory style. Further, in order for both kinds of explanations to be genuinely explanatory, they require reference to broader contexts that are often unavoidably value-laden. (shrink)

François Arago, the first to show in 1810 that the surface of the Sun and stars is made of incandescent gas and not solid or liquid, was a prominent physicist of the 19th century. He used his considerable influence to help Fresnel, Ampere and others develop their ideas and make themselves known. This book covers his personal contributions to physics, astronomy, geodesy and oceanography, which are far from negligible, but insufficiently known. Arago was also an important and influential political man (...) who, for example, abolished slavery in the French colonies. One of the last humanists, he had a very broad culture and range of interests. In parallel to his biography, this title also covers the spectacular progresses of science at the time of Arago, especially in France: the birth of physical optics, electromagnetism and thermodynamics. Francois Arago's life is a fascinating epic tale that reads as a novel. (shrink)

In his Symposium Plato sought to provide for posterity a portrait of his beloved companion and teacher Socrates, focusing on two main features: Socrates as a mystagogue or spiritual guide and Socrates as a paragon of philosophical virtue. Plato’s depiction of these two aspects of the Socratic persona impressed so many writers and artists of later centuries that the Symposium became one of Plato’s best known and most admired dialogues. For many early Christian thinkers Socrates’ account of Erôs or ‘passionate (...) desire’ (imparted to him by the priestess Diotima) established that love is not merely a central aspect of human experience but also the means by which mortal beings achieve union with the divine. Following the lead of Marsilio Ficino, numerous Renaissance poets and artists praised a special ‘Socratic’ or ‘Platonic’ kind of love, inspired by the perception of physical beauty but fully realized in a life of virtuous conduct. -/- . (shrink)

The Socrates of Plato’s dialogues typically practiced elenchos (or cross examination), but neither the term nor the activity originated with him. In fragment 7.3-6 Parmenides of Elea had already spoken off a goddess who directs a youth to judge by reason the poludêrin elenchon spoken by her. Although the meaning of the phrase has been variously understood, I argue that it is properly taken to mean ‘a much-contested testing’ (of the ways of thinking available for inquiry). In characterizing the elenchos (...) as poludêris or ‘much contested’ the goddess was asserting that the decision to follow the ‘it is’ road of inquiry must be continually reaffirmed against the pull of custom and sense experience. Thus, by the time Socrates had begun to practice elenchos on his fellow citizens, there was already a tradition of putting ideas and persons ‘to the test’ to refute their assertions or to certify them as correct. (shrink)